E Forms are standardised forms used throughout the European Union, European Economic Area (Iceland, Norway and Liechtenstein) and Switzerland to speed up the process of claiming social security benefits when you go abroad. They do not apply to other European countries. You obtain the forms from the social security institution of the country where you are insured before you travel abroad. If you are an employee, some E Forms must be applied for by your employer.

E-FORM	Description
E103	Exercising the right of option
E104	Certificate concerning the aggregation of periods of insurance, employment or residence. Allow you to be covered by the social security in your new country.
E105	Certificate concerning the members of the family of an employed person or self-employed person to be taken into consideration for the calculation of cash benefits in the case of incapacity for work
E106	Certificate of entitlement to sickness and maternity insurance benefits in kind for persons residing in a country other than the competent country. Used by people going to work in another country.
E107	Application for a certificate of entitlement to benefits in kind
E108	Notification of suspension or withdrawal of the right to sickness and maternity insurance benefits in kind
E109	Certificate for the registration of members of the employed or self-employed person's family and the updating of lists. For example if the person works in country A and his/her family go to country B within the EU, they will be entitle to medical protection in country B.
E110	Certificate concerning employed persons in international transport. It is replaced by the European Health Insurance Card.
E111	Certificate of entitlement to benefits in kind during a stay in a Member State. This is the most commonly used E Form. It is used by insured people going to another country for a short period, whether for a holiday or for a short business trip, and covers emergency treatment only. It is replaced by the European Health Insurance Card.
E111B	For hospitalisation only - Certificate of entitlement to benefits in kind during a stay in a Member State -Scheme for self-employed persons
E112	Certificate concerning the retention of the right to sickness or maternity benefits currently being provided
E113	Hospitalisation: notification of entering and leaving hospital
E114	Granting of major benefits in kind
E115	Claim for cash benefits for incapacity for work
E116	Medical report relating to incapacity for work (sickness, maternity, accident at work, occupational disease)
E117	Granting of cash benefits in the case of maternity and incapacity for work
E118	Notification of non-recognition or of end of incapacity for work
E118 Annex	Legal remedies and periods allowed for appeals
E119	Certificate concerning the entitlement of unemployed persons and the members of their family to sickness and maternity insurance benefits. It is replaced by the European Health Insurance Card. In addition, if you get unemployment benefits, it will allow you to benefit from the social security back in your country
E120	Certificate of entitlement to benefits in kind for pension claimants and members of their family
E121	Certificate for the registration of pensioners and the updating of lists
E122	Certificate for the granting of benefits in kind to members of the family of pensioners. For example if the person gewts a pension in country A and his/her family go to country B within the EU, they will be entitle to medical protection in country B.
E123	Certificate of entitlement to benefits in kind under insurance against accidents at work and occupational diseases
E124	Claim for death grant
E124 additional	Additional information for the purposes of Portuguese institutions
E125	Individual record of actual expenditure
E125A additional	Additional information for the purposes of Norwegian institutions
E126	Rates for refund of benefits in kind
E127	Individual record of monthly lump-sum payments
E128	Certificate of entitlement to necessary benefits in kind during a stay in a Member State. Covers health care for workers whose social insurance contributions are paid in their country of residence while they work in another country for up to a year. It is replaced by the European Health Insurance Card.
E128B	Certificate of entitlement to necessary benefits in kind during a stay in a Member State : for hospitalisation only - scheme for self-employed persons

The European Health Insurance Card replaces forms:

E111 and E111B used by tourists,

E110 used by international road transporters,

E128 used by students and people working in a Member State other than their own,

E119 used by people registered as unemployed and seeking work in another Member State.

Every Member State is responsible for the distribution of the European Health Insurance Card to its citizens. However, the model of this card is identical and has the same technical specifications in all the Member States, which enables health care providers in every Member State to identify the card immediately.

Every Member State is free to either integrate the technical specifications of the new card within its national card, or to distribute a separate card.

[26-05-2005]